EP3927817A1 - New recombinant diamine oxidase and its use for the treatment of diseases characterized by excess histamine - Google Patents

New recombinant diamine oxidase and its use for the treatment of diseases characterized by excess histamine

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Publication number
EP3927817A1
EP3927817A1 EP20704547.7A EP20704547A EP3927817A1 EP 3927817 A1 EP3927817 A1 EP 3927817A1 EP 20704547 A EP20704547 A EP 20704547A EP 3927817 A1 EP3927817 A1 EP 3927817A1
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EP
European Patent Office
Prior art keywords
dao
specifically
recombinant
amino acid
seq
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EP20704547.7A
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German (de)
English (en)
French (fr)
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Thomas Böhm
Bernd JILMA
Nicole Borth
Elisabeth GLUDOVACZ
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Medizinische Universitaet Wien
Universitaet fuer Bodenkultur Wien BOKU
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Medizinische Universitaet Wien
Universitaet fuer Bodenkultur Wien BOKU
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Publication of EP3927817A1 publication Critical patent/EP3927817A1/en
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    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N9/00Enzymes; Proenzymes; Compositions thereof; Processes for preparing, activating, inhibiting, separating or purifying enzymes
    • C12N9/0004Oxidoreductases (1.)
    • C12N9/0012Oxidoreductases (1.) acting on nitrogen containing compounds as donors (1.4, 1.5, 1.6, 1.7)
    • C12N9/0014Oxidoreductases (1.) acting on nitrogen containing compounds as donors (1.4, 1.5, 1.6, 1.7) acting on the CH-NH2 group of donors (1.4)
    • C12N9/0022Oxidoreductases (1.) acting on nitrogen containing compounds as donors (1.4, 1.5, 1.6, 1.7) acting on the CH-NH2 group of donors (1.4) with oxygen as acceptor (1.4.3)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • A61K38/16Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43Enzymes; Proenzymes; Derivatives thereof
    • A61K38/44Oxidoreductases (1)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P37/00Drugs for immunological or allergic disorders
    • A61P37/08Antiallergic agents
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K14/00Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • C07K14/435Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof from animals; from humans
    • C07K14/76Albumins
    • C07K14/765Serum albumin, e.g. HSA
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K16/00Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies
    • C07K16/40Immunoglobulins [IGs], e.g. monoclonal or polyclonal antibodies against enzymes
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    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12NMICROORGANISMS OR ENZYMES; COMPOSITIONS THEREOF; PROPAGATING, PRESERVING, OR MAINTAINING MICROORGANISMS; MUTATION OR GENETIC ENGINEERING; CULTURE MEDIA
    • C12N15/00Mutation or genetic engineering; DNA or RNA concerning genetic engineering, vectors, e.g. plasmids, or their isolation, preparation or purification; Use of hosts therefor
    • C12N15/09Recombinant DNA-technology
    • C12N15/63Introduction of foreign genetic material using vectors; Vectors; Use of hosts therefor; Regulation of expression
    • C12N15/79Vectors or expression systems specially adapted for eukaryotic hosts
    • C12N15/85Vectors or expression systems specially adapted for eukaryotic hosts for animal cells
    • CCHEMISTRY; METALLURGY
    • C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12YENZYMES
    • C12Y104/00Oxidoreductases acting on the CH-NH2 group of donors (1.4)
    • C12Y104/03Oxidoreductases acting on the CH-NH2 group of donors (1.4) with oxygen as acceptor (1.4.3)
    • C12Y104/03022Diamine oxidase (1.4.3.22)
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16BBIOINFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR GENETIC OR PROTEIN-RELATED DATA PROCESSING IN COMPUTATIONAL MOLECULAR BIOLOGY
    • G16B30/00ICT specially adapted for sequence analysis involving nucleotides or amino acids
    • G16B30/20Sequence assembly
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16BBIOINFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR GENETIC OR PROTEIN-RELATED DATA PROCESSING IN COMPUTATIONAL MOLECULAR BIOLOGY
    • G16B35/00ICT specially adapted for in silico combinatorial libraries of nucleic acids, proteins or peptides
    • G16B35/10Design of libraries
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00Medicinal preparations containing peptides
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K2319/00Fusion polypeptide
    • C07K2319/30Non-immunoglobulin-derived peptide or protein having an immunoglobulin constant or Fc region, or a fragment thereof, attached thereto
    • CCHEMISTRY; METALLURGY
    • C07ORGANIC CHEMISTRY
    • C07KPEPTIDES
    • C07K2319/00Fusion polypeptide
    • C07K2319/31Fusion polypeptide fusions, other than Fc, for prolonged plasma life, e.g. albumin

Definitions

  • the present invention refers to a recombinant diamine oxidase (DAO) with decreased glycosaminoglycan binding affinity, wherein said DAO comprises at least one amino acid modification in the glycosaminoglycan (GAG) binding domain.
  • DAO diamine oxidase
  • the present invention also refers to the use of the DAO in the treatment of a condition associated with excess histamine, specifically in the treatment of chronic allergic diseases and/or in the treatment of high risk pregnancy, more specifically in the treatment of anaphylaxis, anaphylactic shock, chronic urticaria, acute urticaria, asthma, hay fever, allergic rhinitis, allergic conjunctivitis, histamine intoxication, headache, atopic dermatitis inflammatory diseases, mastocytosis, mast cell activation syndrome (MCAS), pre-eclampsia, hyperemesis gravidarum, pre-term labor, peptic ulcers, acid reflux, pruritus, and sepsis.
  • MCAS mast cell activation syndrome
  • Histamine (2-(1 /-/-lmidazol-4-yl)ethanamine) is an organic nitrogenous compound involved in local immune responses, regulating physiological function in the gut and acting as a neurotransmitter for the brain, spinal cord, and uterus. Histamine is involved in the inflammatory response and has a central role as a mediator of itching. As part of an immune response to foreign pathogens, histamine is produced by basophils and by mast cells found in nearby connective tissues. It is stored in inactive form in the metachromatic granules of the mast cells and basophilic leukocytes, where it is available for an immediate release. Histamine can also be freshly synthesized by neutrophils and macrophages during inflammation.
  • histamine is a powerful physiological and pathological mediator binding to four receptors (Hi - H4) expressed on many different cells in the body. Binding of histamine to its receptors is very specific. After binding many downstream activities are induced. Acute allergic reactions such as hay fever, runny nose, itchy eyes or in more severe cases asthma with breathing problems; acute and chronic urticaria and hypersensitivity reactions, also called anaphylaxis for example caused by medications especially antibiotics or radio contrast agents, by a peanut or wasp allergy etc., are mediated by tissue mast cells and basophils in the blood releasing several mediators of which histamine is one of the most active ones.
  • Histamine-induced symptoms include anaphylaxis, a hypersensitivity reaction with drop in blood pressure, fainting and breathing problems among other symptoms, bronchospasm, flushing (reddening of the skin), pruritus (itchiness), tachycardia (high pulse rate), syncope (fainting), hypotension (low blood pressure), epigastric and abdominal pain, nausea, vomiting, diarrhea, fatigue, memory loss, depression and headache among others.
  • Excess histamine >10 ng/ml; symptoms start at 1 to 3 ng/ml
  • Histamine concentration in blood of approximately 100 ng/ml can result in cardiac arrest.
  • hyperhistaminemia can lead to specific gestational complications such as preeclampsia, spontaneous abortion, preterm labour and hyperemesis gravidarum (Brew O. and Sullivan M.H.F., J.Reprod. Immunol., 72(2006), 94-107, Maintz L. et al., Human Reproduction Update, 14,5, 2008, 485-495).
  • mast cells and basophils are cells of the immune system with many different functions. Nevertheless, mast cells and histamine play an important role in many diseases like mast cell activation syndromes, MCAS, i.e. inability to tolerate histamine in red wine or cheese or other foods; in literature often described as histamine intolerance, atopic dermatitis (also called neurodermitis, a skin disease), mastocytosis (increased number of mast cells in the skin and/or internal organs like the bone marrow or liver or spleen), peptic ulcers (damage of the mucosa in the stomach or duodenum caused by excessive histamine followed by acid release), acid reflux, headache, pruritus and possibly even sepsis among other diseases. Histamine can be also newly synthesized by histidine decarboxylase induced in for example neutrophils and macrophages under certain disease conditions.
  • histamine may also get into the body from the outside, by inhaling, or orally, e.g. by ingesting histamine-containing foodstuffs, such as cheese, wine, canned fish and sauerkraut. Histamine can also be produced by bacteria of the microbiome.
  • Anti-histamines opposing the activity of histamine receptors Hi and H2 have been available for several decades and they are assumed to be efficacious in treating symptoms such as runny nose and itching skin and eyes. Anti-histamines are one of the most frequently prescribed medications worldwide. Nevertheless, thorough data analysis has clearly shown that the efficacy of anti-histamines is limited under several pathological conditions. For example, about 25% of chronic urticaria patients are anti histamine resistant and suffer from a low quality of life. Treatment of hypersensitivity reactions with anti-histamines is widely practiced but high quality efficacy data are missing and in some documents a lack of efficacy is stated. Anaphylaxis guidelines do not necessarily recommend the use of histamine Hi receptor blocker for the treatment because the evidence of benefit is not clear. The use of histamine H2 receptors antagonists in anaphylaxis is discouraged because it can worsen the symptoms.
  • histamine is degraded by two enzymes: diamine oxidase (diamine oxidase, DAO, EC 1.4.3.6) and histamine-N-methyltransferase (HNMT or short NMT, EC 2.1.1.8).
  • DAO diamine oxidase
  • HNMT histamine-N-methyltransferase
  • NMT catalyzes the N-methylation to N-methyl-histamine.
  • DAO catalyzes the oxidative deamination of histamine to imidazole acetaldehyde.
  • DAO was originally identified as the enzyme that cleared exogenous histamine from minced lung and liver samples and was therefore termed histaminase (Best CH., J. Physiol., 1929, 67, 256-263).
  • a protein identified as diamine oxidase was termed amiloride-binding protein, and was incorrectly implicated with the amiloride-sensitive Na + channel.
  • DAO contains a heparin binding consensus sequence (residues 568-575), it could not be derived from this structure that the heparin-binding domain really binds heparin.
  • a 12-mer heparin molecule is ⁇ 5 nm (50 A) long and the diameter of the circular heparin binding domain in DAO is about 25 A.
  • hDAO is the frontline enzyme for degradation of exogenous histamine and reduced levels of DAO have been shown to be directly correlated with histamine intolerance (Maintz L. et al., Am.J.CIin.Nutr., 2007, 85, 1185-1196). Reduced DAO activities have been found in multiple heterogenous complications of pregnancy such as diabetes, threatened and missed abortion and trophoblastic disorders (Maintz L., et al., 2008).
  • DAO degrades histamine from the diet to avoid and to protect the body from increased concentrations in the blood. Nevertheless, except during pregnancy, DAO antigen and consequently activity is low or even absent in plasma (Boehm T. et al., Clinical Biochemistry 50, 2017, 444-451). During pregnancy DAO activity is increased more than 100-fold.
  • W02006/003213A1 describes specific administration formulations of animal derived or recombinantly produced DAO.
  • WO 2012/028891 A1 reports histaminase from vegetable origin. Because released histamine cannot be blocked or inactivated efficiently by anti-histamines, new treatment and prophylaxis approaches for rapid inactivation of excess histamine would be of significant benefit to patients suffering from high circulatory histamine concentrations. Many patients suffer for hours from increased histamine concentrations. The half-life of histamine is even increased during anaphylaxis and hypotension due to reduced kidney filtration and blood flow.
  • the objective is solved by the present invention by the provision of a recombinant modified DAO to increase the concentration of active DAO within the body of an individual to thereby assist in, or enable, respectively, the degradation of histamine.
  • a recombinant human diamine oxidase (DAO) with decreased glycosaminoglycan (GAG) binding affinity compared to the GAG binding affinity of the respective wild type human DAO wherein said DAO comprises at least one amino acid modification in the glycosaminoglycan (GAG) binding domain, specifically the GAG binding domain comprises the amino acids at positions 568-575 with reference to the numbering of SEQ ID NO:1.
  • the GAG binding domain is a heparin/heparan sulfate binding domain.
  • amino acid modification results in decreased GAG binding affinity of the DAO while its enzymatic activity towards histamine is preserved.
  • the at least one amino acid modification in the GAG binding domain of the DAO is an amino acid substitution, deletion, insertion or coupling with a chemical moiety.
  • the recombinant DAO of the invention comprises 2, 3, 4, 5, 6, 7, or 8 amino acid modifications in the GAG binding domain.
  • said amino acid residues are substituted by other amino acid residues, specifically arginine or lysine is substituted by serine or threonine.
  • the recombinant DAO comprises a GAG binding domain of amino acid sequence X1 FX2X3X4LPX5, wherein
  • X1 can be by any amino acid, specifically it is A or S, more specifically it is S;
  • X2 can be by any amino acid, specifically it is K;
  • X3 can be by any amino acid, specifically it is A or T, more specifically it is T,
  • X4 can be by any amino acid, specifically it is K, and
  • X5 can be by any amino acid, specifically it is K or T, more specifically it is T.
  • the recombinant DAO comprises the amino acid sequence selected from the group consisting of SFKAKLPK (SEQ ID NO:33), AFKAKLPT (SEQ ID NO:34), AFKTKLPK (SEQ ID NO:35), SFKTKLPK (SEQ ID NO:36), AFKTKLPT (SEQ ID NO:37), SFKAKLPK (SEQ ID NO:38).
  • the recombinant DAO as disclosed herein further comprises at least one modification of the solvent accessible cysteine at amino acid position 123 (cys123) with reference to the numbering of SEQ ID No. 1 , specifically the modification of the cysteine is an amino acid substitution, deletion or conjugation with a chemical moiety.
  • cys123 according to the numbering of SEQ ID 1 of DAO is substituted by alanine (cys123ala, C123A).
  • the DAO of the invention specifically shows reduced clearance from plasma.
  • the invention specifically provides a recombinant DAO which has significantly increased plasma half-life compared to wild type DAO, specifically said half-life is increased at least
  • the DAO has an at least 10-fold increased AUC compared to wild type DAO.
  • internalization of the recombinant DAO by endothelial cells is at least 10%, 25%, 50%, 60%, 70%, 80%, specifically 90% reduced compared to wild type DAO.
  • the GAG binding affinity of the DAO as described herein, specifically the heparin/heparan sulfate binding affinity is at least 10%, 25%, 50%, 60%, 70%, 80%, specifically 90% reduced compared to wild type DAO.
  • Human DAO also has multiple N-glycosylation sites playing a role in secretion and retention in the endoplasmatic reticulum. Specifically, glycans at Asn-168 are predominantly sialylated with bi- to tetra-antennary branches.
  • the recombinant DAO described herein further comprises a modification, specifically an amino acid substitution at position 168 with reference to SEQ ID NO 1.
  • the modification is a single modification at position 168. More specifically, Asn is replaced by Gin.
  • said modification increases the PK of the DAO described herein. More specifically, the DAO comprises the amino acid sequence of SEQ ID NO:106.
  • a recombinant DAO or a functional derivative or analogue thereof encoded by any one of SEQ ID NOs: 17, 18, 19, 20, 21 , 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 or 32 or having at least 90% sequence identity with any one of SEQ ID NOs: 17, 18, 19, 20, 21 , 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 or 32.
  • nucleotide sequence encoding the DAO or a functional analogue or derivative thereof as described herein, specifically comprising sequences SEQ ID NOs: 17, 18, 19, 20, 21 , 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 or 32 or fragments thereof.
  • a fusion polypeptide comprising the recombinant DAO described herein and an Fc domain of human IgG or human serum albumin (HSA) or a fragment thereof, wherein the fusion polypeptide retains the functional activity of the recombinant DAO.
  • HSA human serum albumin
  • fusion polypeptide comprising the recombinant DAO described herein and an Fc domain of human IgG comprising the sequences of any one of SEQ ID Nos:56 to 70 or having at least 90% sequence identity with any one of SEQ ID Nos: 56 to 70.
  • fusion polypeptide comprising the recombinant DAO described herein and an Fc domain of human IgG or a functional derivative or analogue thereof encoded by any one of SEQ I D NOs: 72 to 102 or having at least 90% sequence identity with any one of SEQ ID NOs: 72 to 102.
  • a recombinant vector comprising the nucleotide sequence described herein, specifically the vector is a bacterial, yeast, baculoviral, plant or mammalian expression vector.
  • an expression cassette comprising the nucleotide sequence, operably linked to regulatory elements.
  • a recombinant host cell or a host cell line of bacterial, yeast, baculoviral, plant or mammalian origin comprising the recombinant DAO described herein, wherein the host cells are specifically selected from the group consisting of CHO cells, Vero cells, MDCK cells, Pichia pastoris cells, and SF9 cells.
  • an expression system comprising the vector, or the expression cassette and a host cell, or host cell line described herein.
  • a pharmaceutical composition comprising the recombinant DAO and optionally one or more excipients.
  • the pharmaceutical composition can be applied intravenously, intramuscularly and subcutaneously or via other parenteral routes of administration like intraperitoneally or intrathecally.
  • the use of the recombinant DAO for preparing a pharmaceutical composition is provided.
  • the recombinant DAO is provided for use in the treatment of a condition associated with excess histamine, specifically for the treatment of chronic allergic diseases or diseases associated with increase of histamine or decreased DAO activity, more specifically for the treatment of anaphylaxis, anaphylactic shock, chronic urticaria, acute urticaria, asthma, hay fever, allergic rhinitis, allergic conjunctivitis, histamine intoxication, headache, atopic dermatitis inflammatory diseases, mastocytosis, mast cell activation syndrome (MCAS), pre-eclampsia, hyperemesis gravidarum, pre-term labor, peptic ulcers, acid reflux, pruritus, and sepsis.
  • a condition associated with excess histamine specifically for the treatment of chronic allergic diseases or diseases associated with increase of histamine or decreased DAO activity
  • anaphylaxis anaphylactic shock, chronic urticaria, acute urticaria, asthma, hay fever, allergic rhinitis, allergic conjun
  • the use of the recombinant DAO is encompassed for the manufacture of a medicament for the treatment of a condition associated with excess histamine, specifically for the treatment of chronic allergic diseases, or diseases associated with increase of histamine or decreased DAO activity, more specifically for the treatment of anaphylaxis, anaphylactic shock, chronic urticaria, acute urticaria, asthma, hay fever, allergic rhinitis, allergic conjunctivitis, histamine intoxication, headache, atopic dermatitis inflammatory diseases, mastocytosis, mast cell activation syndrome (MCAS), pre-eclampsia, hyperemesis gravidarum, pre-term labor, peptic ulcers, acid reflux, pruritus, and sepsis.
  • MCAS mast cell activation syndrome
  • a target-specific ligand specifically binding to the GAG binding domain of DAO, specifically binding to one or more of amino acids at position 568-575 with reference to the numbering of SEQ ID No. 1
  • a target-specific ligand specifically inhibiting heparin/heparan sulfate binding to the GAG binding domain of DAO, specifically to any one or more of amino acids at position 568-575 with reference to the numbering of SEQ ID No. 1.
  • the ligand is selected from the group consisting of nucleic acid, small molecule inhibitor or antigen binding protein.
  • the ligand is an antigen binding protein, specifically selected from the group consisting of antibodies or antibody fragments, such as any of Fab, Fd, scFv, diabodies, triabodies, Fv tetramers, minibodies, nanobodies, single-domain antibodies like VH, VHH, IgNARs, or V-NAR;
  • antibody mimetics such as AdnectinsTM, Affibodies®, Affilins®, Affimers®, Affitins, Alphabodies, Aptamers, Anticalins, Avimers, DARPins®, Fynomers®, Kunitz domain peptides, Monobodies, or NanoCLAMPS; or
  • fusion proteins comprising one or more immunoglobulin-fold domains, antibody domains or antibody mimetics.
  • herein provided is a method for identifying compounds which modulate the heparin binding of the DAO, comprising the steps of
  • Figure 1 Amino acid and nucleotide sequences of wild type DAO and modified DAO.
  • Bold letters refer to substitutions compared to wt sequences; underlined letter refer to secretion signal; bold, italic letters refer to Fc, bold, italic and underlined letters refer to linker sequences from lgG1 hinge region.
  • FIG. 2 Heparin-sepharose elution profiles of recombinant human DAO wild type and heparin/heparan sulfate mutants.
  • Figure 3 Hepmut 1 , 4 and 7 variants are eluted from heparin-sepharose at 50% lower salt concentrations compared to DAO_WT.
  • Figure 4 Western blot of SK-Hep1 cell lysates after incubation with DAO_WT and Hepmut variants
  • Hepmut4 variant shows reduced binding to SK-Hep1 cells compared to DAO_WT.
  • Figure 7 Linear (a) und log y-scales (b) are shown. Hepmut4 increases the AUC (Area Under the Curve) more than 19-fold compared to wild type DAO protein after intravenous injection of 1 mg/kg DAO variants.
  • Figure 8 Hepmut4 increases the AUC more than 16-fold compared to DAO_WT protein after intraperitoneal injection.
  • Figure 9 Means of the measured values using 1 mg/kg DAO wild-type and different Hepmut variants.
  • Figure 10 Slow clearance of heparin/heparan sulfate-binding domain mutants compared to DAO wild type protein administered at 1 mg/kg.
  • Figure 11 Slow clearance of heparin-binding domain mutants compared to DAO wild type protein.
  • Figure 12 Slow clearance of heparin-binding domain mutants compared to DAO wild type protein administered at 1 mg/kg.
  • Figure 13 Slow clearance of heparin-binding domain mutants compared to DAO wild type protein administered at 1 mg/kg. Linear y-axis scale.
  • Figure 14 Slow clearance of heparin-binding domain mutants compared to DAO wild type protein administered at 1 mg/kg. The first 90 minutes are shown; Linear y-axis scale.
  • Figure 15 Rapid clearance of Fc-DAO wild-type compared to Fc-Hepmut4 administered at 1 mg/kg in 6 or 4 rats respectively. The means with the standard deviations are shown; Linear y-axis scale.
  • Figure 16 Rapid clearance of Fc-DAO wild type compared to Fc-Hepmut4 administered at 1 mg/kg in 6 or 4 rats respectively. The means with the standard deviations are shown; Log y-axis scale.
  • FIG. 17 Fc-DAO-Hepmut4 shows a strong increase in the AUC after intravenous administration of 1 mg/kg; Log y-axis scale.
  • Figure 18 Fc-DAO-Hepmut4 shows a strong increase in the AUC after intravenous administration of 1 mg/kg; Linear y-axis scale.
  • Figure 19 Western blot of DAO mutants.
  • Human DAO monomer comprises about 751 amino acids and forms dimers which are enzymatically active. Of 14 cysteines in the DAO dimer, 10 of them are involved in S-S formation and 4 are not. Specifically, cysteine 123 and 633 are not involved in disulfide bond formation.
  • amino acids refer to twenty naturally occurring amino acids encoded by sixty-four triplet codons. These 20 amino acids can be split into those that have neutral charges, positive charges, and negative charges:
  • Alanine (Ala, A) nonpolar, neutral;
  • Asparagine (Asn, N) polar, neutral
  • Cysteine (Cys, C) nonpolar, neutral
  • Glutamine (Gin, Q) polar, neutral
  • Glycine (Gly, G) nonpolar, neutral
  • Leucine (Leu, L) nonpolar, neutral
  • Methionine (Met, M) nonpolar, neutral
  • Phenylalanine (Phe, F) nonpolar, neutral;
  • Proline (Pro, P) nonpolar, neutral
  • Serine (Ser, S) polar, neutral
  • Threonine (Thr, T) polar, neutral
  • Tryptophan (Trp, W) nonpolar, neutral;
  • Tyrosine (Tyr, Y) polar, neutral
  • Valine (Val, V) nonpolar, neutral
  • Histidine (His, H) polar, positive (10%) neutral (90%).
  • The“positively” charged amino acids are:
  • Arginine (Arg, R) polar, positive
  • Lysine (Lys, K) polar, positive.
  • The“negatively” charged amino acids are:
  • Aspartic acid (Asp, D) polar, negative;
  • Glutamic acid (Glu, E) polar, negative.
  • modification of the inventive DAO refers to any amino acid sequence alteration including, but not limited to, amino acid substitutions, additions, deletions, mutations, and insertions. Modifications can also be chemoselective modifications. Such modification can be a conjugation or coupling with a chemical moiety wherein a stable covalent link is formed between two molecules, at least one of which is a biomolecule.
  • Such conjugation can be formed with one or more amino acid residues, such as, but not limited to, conjugation with maleimides, iodoacetamides, isoacetoamides, 2-thiopyridine, 3-arylpropiolonitrile, benzoyl fluorides, isothyocyanates, isocyanates, diazonium salts, PTAD, Nal04, or PLP.
  • amino acid residues such as, but not limited to, conjugation with maleimides, iodoacetamides, isoacetoamides, 2-thiopyridine, 3-arylpropiolonitrile, benzoyl fluorides, isothyocyanates, isocyanates, diazonium salts, PTAD, Nal04, or PLP.
  • cysteine at amino acid position 633 may also be modified as described herein for cys123. Cys633 is also not involved in disulfide bond formation.
  • cysteine residues can be deprotonated to generate a thiolate nucleophile, which will react with soft electrophiles, such as maleimides and iodoacetamides. As a result, a carbon-sulfur bond is formed.
  • Another modification of cysteine residues involves the formation of disulfide bond. The reduced cysteine residues react with exogenous disulfides, generating new disulfides bond on protein. An excess of disulfides is often used to drive the reaction, such as 2-thiopyridone and 3- carboxy-4-nitrothiophenol.
  • Electron-deficient alkynes were demonstrated to selectively react with cysteine residues of proteins in the presence of other nucleophilic amino acid residues. Depending on the alkyne substitution, these reactions can produce either cleavable (when alkynone derivatives are used), or hydrolytically stable bioconjugates (when 3-arylpropiolonitriles are used).
  • Unnatural amino acids are not encoded by the Universal Genetic Code. Usually they can be found in nature as metabolic products, especially in plants and bacteria. Such unnatural amino acids can be selected from, but are not limited to D-amino acids, homo amino acids, N-methyl amino acids, alpha methyl amino acids, beta 2 amino acids, beta 3 amino acids, beta 3 homo amino acids, ACHC, peptoids or heavy amino acids, specifically substituted with 13C and/or 15N atoms, specifically E-acetyl-lysine, alanine(3-amino-proprionic acid), 6-aminocaproic acid, ?- aminobutyric acid, citrulline, cysteine acetamidomethyl protected, dimethyl-lysine, hydroxyl-proline, mercaptoproprionic acid, methyl-lysine, 3-notro-tyrosine, norleucines, pyro glutamic acid, carbobenzoxyl.
  • glycosaminoglycans include heparin/heparan sulfate, chondroitin/dermatan sulfate, keratin sulfate, and hyaluronan. Binding to heparin/heparan sulfate is preferred. Heparin is present in mast cells. Heparan sulfate is present on almost all cells such as endothelial cells.
  • GAG binding refers to the interaction/binding of DAO with glycosaminoglycan, specifically with heparin or heparan sulfate.
  • GAGs bind to many different classes of proteins mostly through electrostatic interactions between negatively charged sulfate groups and uronic acids and positively charged amino acids in the protein.
  • Heparin binding affinity can be determined by any method known to the skilled person. Numerous methods are available for analyzing GAG-protein interactions, and some provide a direct measurement of Kd values. A common method involves affinity fractionation of proteins on sepharose columns containing covalently linked GAG chains, usually heparin. The bound proteins are eluted with different concentrations of sodium chloride, and the concentration required for elution is generally proportional to the Kd.
  • High-affinity interactions require at least 1 M NaCI to displace bound ligand, which translates into Kd values of 10 -7 — 10 -9 M (determined under physiological salt concentrations by equilibrium binding). Proteins with low affinity (10 -4 — 10 -6 M) either do not bind under“normal” conditions (0.15 M NaCI) or require only 0.3-0.5 M NaCI to elute. This method is based on the assumption that GAG-protein interaction is entirely ionic and can provide an assessment of relative affinity, when comparing different GAG- binding proteins.
  • Alternative methods can be, but are not limited to affinity co electrophoresis, analytical ultracentrifugation, circular dichroism, competition ELISA, fluorescence microscopy, ion mobility mass spectrometry, isothermal titration calorimetry, laser light scattering, NMR, surface plasmon resonance, and X-ray and thereby provide detailed thermodynamic data (DA7 [change in enthalpy], AS [change in entropy], ACp [change in molar heat capacity], etc.), kinetic data (association and dissociation rates), and high-resolution data on atomic contacts in GAG-protein interactions (Esko JD. et al., Essentials of Glycobiology, 3 rd edition, Chapter 38, 2017).
  • the DAO mutants as described herein have diminished or show reduced binding to heparin and/or heparan sulfate.
  • heparin/heparan sulfate binding affinity of the recombinant DAO is at least 10%, 25%, 50%, 60%, 70%, 80%, specifically 90% reduced compared to wild type DAO.
  • binding affinity is determined using heparin-sepharose chromatography, wherein the DAO variants are incubated at low salt concentrations and eluted with increasing salt concentrations. The salt concentrations with the peak in DAO protein (measured using absorbance at 280 nm) is used as the mM salt concentration at which DAO is eluted.
  • the DAO of the invention further show decreased internalization into endothelial cells compared to wild type DAO which is internalized. Specifically, internalization by endothelial cells is at least 10%, 25%, 50%, 60%, 70%, 80%, specifically 90% reduced compared to wild type DAO.
  • the GAG binding domain comprises amino acids at positions 568- 575 with reference to the numbering of SEQ ID NO:1. Within said domain, 1 , 2, 3, 4, 5, 6, 7, or all amino acids can be modified.
  • a DAO monomer contains 24 lysines and 44 arginines in the primary amino acid sequence, most of them being on the surface of the molecule. It is likely that other lysines and arginines are involved in heparin binding. Besides the GAG binding domain encompassing amino acids at positions 568-575 further lysines or arginines on the surface of DAO may be involved in heparin/heparan sulfate binding.
  • Modification of one or more of these lysines and/or arginines may further decrease heparin/heparan sulfate binding of the recombinant DAO.
  • the term “enzymatic activity” of DAO refers to the polypeptide ' s ability to catalyze the oxidative deamination of an appropriate substrate like putrescine or histamine to aminobutyraldehyde or imidazole acetaldehyde.
  • Preservation of enzymatic activity means that the DAO of the invention has the same or similar enzymatic activity as the respective wild type DAO.
  • Enzymatic activity that is at least 80%, specifically at least 90% of the wild type activity is interpreted to be the similar enzymatic activity as a wild type DAO.
  • any methods can be used known in the art.
  • HRP horseradish peroxidase
  • spectrophotometric methods as described by Holmstedt B.O. and Tham R. (Acta Physiol. Scand., 1959, 45, 152-163) and Bardsley W.G. et al., (Biochem.J. 1972, 127, 875-879), mass spectrometry (Gludovacz E. et al., 2016), liquid scintillation counting (Okuyama T. and Kobayashi Y., Archives Biochem.
  • HRP horseradish peroxidase
  • allelic variant or “functionally active variant” also includes naturally occurring allelic variants, as well as mutants or any other non-naturally occurring variants.
  • an allelic variant is an alternate form of a nucleic acid or peptide that is characterized as having a substitution, deletion, or addition of one or more nucleotides or one or more amino acids that does essentially not alter the biological function of the nucleic acid or polypeptide.
  • Functional variants may be obtained by sequence alterations in the polypeptide or the nucleotide sequence, e.g. by one or more point mutations, wherein the sequence alterations retain or improve a function of the unaltered polypeptide or the nucleotide sequence, when used in combination of the invention.
  • sequence alterations can include, but are not limited to, (conservative) substitutions, additions, deletions, mutations and insertions.
  • Conservative substitutions are those that take place within a family of amino acids that are related in their side chains and chemical properties. Examples of such families are amino acids with basic side chains, with acidic side chains, with non-polar aliphatic side chains, with non-polar aromatic side chains, with uncharged polar side chains, with small side chains, with large side chains etc.
  • a point mutation is particularly understood as the engineering of a poly nucleotide that results in the expression of an amino acid sequence that differs from the non-engineered amino acid sequence in the substitution or exchange, deletion or insertion of one or more single (non-consecutive) or doublets of amino acids for different amino acids.
  • a GAG binding domain can be introduced into DAO at any position within the polypeptide by recombinant means.
  • the respective domain can be comprised of amino acid sequence X1 FX2X3X4LPX5, X1 being any amino acid, specifically being A or S, more specifically being S; X2 being any amino acid, specifically being K; X3 being any amino acid, specifically A or T, more specifically T, X4 being any amino acid, specifically K, and X5 being any amino acid, specifically K or T, more specifically T.
  • amino acid sequences SFKAKLPK (SEQ ID NO:33), AFKAKLPT (SEQ ID NO:34), AFKTKLPK (SEQ ID NO:35), SFKTKLPK (SEQ ID NO:36), AFKTKLPT (SEQ ID NO:37), SFKAKLPK (SEQ ID NO:38) are introduced into the DAO polypeptide described herein.
  • sequence identity is understood as the relatedness between two amino acid sequences or between two nucleotide sequences and described by the degree of sequence identity or sequence complementarity.
  • sequence identity of a variant, homologue or orthologue as compared to a parent nucleotide or amino acid sequence indicates the degree of identity of two or more sequences.
  • Two or more amino acid sequences may have the same or conserved amino acid residues at a corresponding position, to a certain degree, up to 100%.
  • Two or more nucleotide sequences may have the same or conserved base pairs at a corresponding position, to a certain degree, up to 100%.
  • Sequence similarity searching is an effective and reliable strategy for identifying homologs with excess (e.g., at least 50%) sequence identity. Sequence similarity search tools frequently used are e.g., BLAST, FASTA, and HMMER.
  • Sequence similarity searches can identify such homologous proteins or polynucleotides by detecting excess similarity, and statistically significant similarity that reflects common ancestry.
  • Homologues may encompass orthologues, which are herein understood as the same protein in different organisms, e.g., variants of such protein in different different organisms or species.
  • one of the two sequences needs to be converted to its complementary sequence before the % complementarity can then be calculated as the % identity between the first sequence and the second converted sequences using the above-mentioned algorithm.
  • Percent (%) identity with respect to an amino acid sequence, homologs and orthologues described herein is defined as the percentage of amino acid residues in a candidate sequence that are identical with the amino acid residues in the specific polypeptide sequence, after aligning the sequence and introducing gaps, if necessary, to achieve the maximum percent sequence identity, and not considering any conservative substitutions as part of the sequence identity.
  • Those skilled in the art can determine appropriate parameters for measuring alignment, including any algorithms needed to achieve maximal alignment over the full length of the sequences being compared.
  • sequence identity between two amino acid sequences is determined using the NCBI BLAST program version 2.2.29 (Jan-06-2014) with blastp set at the following exemplary parameters: Program: blastp, Word size: 6, Expect value: 10, Hitlist size: 100, Gapcosts: 1 1.1 , Matrix: BLOSUM62, Filter string: F, Genetic Code: 1 , Window Size: 40, Threshold: 21 , Composition-based stats: 2.
  • Percent (%) identity with respect to a nucleotide sequence e.g., of a nucleic acid molecule or a part thereof, in particular a coding DNA sequence, is defined as the percentage of nucleotides in a candidate DNA sequence that is identical with the nucleotides in the DNA sequence, after aligning the sequence and introducing gaps, if necessary, to achieve the maximum percent sequence identity, and not considering any conservative substitutions as part of the sequence identity. Alignment for purposes of determining percent nucleotide sequence identity can be achieved in various ways that are within the skill in the art, for instance, using publicly available computer software. Those skilled in the art can determine appropriate parameters for measuring alignment, including any algorithms needed to achieve maximal alignment over the full length of the sequences being compared.
  • Optimal alignment may be determined with the use of any suitable algorithm tor aligning sequences, non-limiting examples of which include the Smith-Waterman algorithm, the Needleman-Wunsch algorithm, algorithms based on the Burrows-Wheeler Transform (e.g., the Burrows Wheeler Aligner), ClustalW, Clustal X, BLAT, Novoalign (Novocraft Technologies; available at novocraft.com), ELAND (lllumina, San Diego, CA), SOAP (available at soap.genomies.org.cn), and Maq (available at maq.sourceforge.net).
  • Burrows-Wheeler Transform e.g., the Burrows Wheeler Aligner
  • ClustalW Clustal X
  • BLAT Novoalign
  • ELAND lllumina, San Diego, CA
  • SOAP available at soap.genomies.org.cn
  • Maq available at maq.sourceforge.net.
  • the DAO as described herein can comprise the amino acid sequences of SEQ ID NOs:2 to 16 and any functional variants thereof having 90%, 95%, 99% sequence identity with any of SEQ ID NOs:2 to 16.
  • the recombinant DAO has increased plasma half-life compared to wild type DAO, specifically said half-life is increased at least 1.5 fold, specifically at least 2 fold compared to wild type DAO.
  • the duration of action or physical presence of a drug is known as its half-life. This is the period of time required for the concentration or amount of drug in the body or whole blood or plasma to be reduced by one-half.
  • Half-life of a drug is usually considered in relation to the amount of the drug in plasma or serum.
  • a drug's plasma or serum half- life depends on how quickly the drug is eliminated from the plasma or serum.
  • a drug molecule may be eliminated from the body, or it can be translocated to another body fluid compartment such as the intracellular fluid or it can be destroyed in the blood.
  • the removal of a drug from the plasma is known as clearance and the distribution of the drug in the various body tissues is known as the volume of distribution.
  • the area under the plasma drug concentration-time curve (AUC) reflects the actual body exposure to drug, i.e. the recombinant DAO described herein, after administration of a dose of the drug and is expressed in pg/min/ml. This area under the curve is dependent on the rate of elimination of the drug from the body and the dose administered.
  • the total amount of drug eliminated by the body may be assessed by adding up or integrating the amounts eliminated in each time interval, from time zero (time of the administration of the drug) to infinite time. This total amount corresponds to the fraction of the dose administered that reaches the systemic circulation.
  • the AUC is directly proportional to the dose when the drug follows linear kinetics.
  • the AUC is inversely proportional to the clearance of the drug. That is, the higher the clearance, the less time the drug spends in the systemic circulation and the faster the decline in the plasma drug concentration. Therefore, in such situations, the body exposure to the drug and the area under the concentration-time curve are smaller.
  • the recombinant DAO as described herein has an at least 2-fold, at least 5-fold, 10-fold, at least 15-fold, at least 20-fold, at least 25-fold, at least 30-fold increased AUC compared to wild type DAO.
  • nucleic acid molecules containing a desired coding sequence of an expression product such as e.g., a fusion protein as described herein may be used for expression purposes. Hosts transformed or transfected with these sequences are capable of producing the encoded proteins.
  • the expression system may be included in a vector; however, the relevant DNA may also be integrated into the host chromosome.
  • the term refers to a host cell and compatible vector under suitable conditions, e.g., for the expression of a protein coded for by foreign DNA carried by the vector and introduced to the host cell.
  • Coding DNA is a DNA sequence that encodes a particular amino acid sequence for a particular polypeptide or protein.
  • Promoter DNA is a DNA sequence which initiates, regulates, or otherwise mediates or controls the expression of the coding DNA.
  • Promoter DNA and coding DNA may be from the same gene or from different genes, and may be from the same or different organisms.
  • Recombinant cloning vectors often include one or more replication systems for cloning or expression, one or more markers for selection in the host, e.g., antibiotic resistance, one or more nuclear localization signals (NLS) and one or more expression cassettes.
  • “Expression vector” as used herein is defined as DNA sequences that are required for the transcription of cloned recombinant nucleotide sequences, i.e. of recombinant genes and the translation of their mRNA in a suitable host organism.
  • a sequence encoding a desired expression product such as the DAO described herein, is typically cloned into an expression vector that contains a promoter to direct transcription.
  • Suitable bacterial and eukaryotic promoters are well known in the art.
  • the promoter used to direct expression of a nucleic acid depends on the particular application. For example, a strong constitutive promoter is typically used for expression and purification of fusion proteins.
  • a constitutive or an inducible promoter can be used, depending on the particular use of the expression product.
  • a preferred promoter for administration can be a weak promoter.
  • the promoter can also include elements that are responsive to transactivation, e.g., hypoxia response elements, Gal4 response elements and lac repressor response elements.
  • Expression vectors comprise the expression cassette and additionally usually comprise an origin for autonomous replication in the host cells or a genome integration site, one or more selectable markers (e.g., an amino acid synthesis gene or a gene conferring resistance to antibiotics such as zeocin, kanamycin, G418 or hygromycin), a number of restriction enzyme cleavage sites, a suitable promoter sequence and a transcription terminator, which components are operably linked together.
  • selectable markers e.g., an amino acid synthesis gene or a gene conferring resistance to antibiotics such as zeocin, kanamycin, G418 or hygromycin
  • An“expression cassette” refers to a DNA coding sequence or segment of DNA coding for an expression product that can be inserted into a vector at defined restriction sites.
  • the cassette restriction sites are designed to ensure insertion of the cassette in the proper reading frame.
  • foreign DNA is inserted at one or more restriction sites of the vector DNA, and then is carried by the vector into a host cell along with the transmissible vector DNA.
  • a segment or sequence of DNA having inserted or added DNA, such as an expression vector, can also be called a“DNA construct”.
  • recombinant host cells may be selected from CHO cells, COS cells, Vero cells, MDCK cells, Pichia pastoris cells, SF9 cells, human cell lines such as HEK and HeLa.
  • vector includes autonomously replicating nucleotide sequences as well as genome integrating nucleotide sequences.
  • a common type of vector is a“plasmid”, which generally is a self-contained molecule of double-stranded DNA that can readily accept additional (foreign) DNA and which can readily be introduced into a suitable host cell.
  • a plasmid vector often contains coding DNA and promoter DNA and has one or more restriction sites suitable for inserting foreign DNA.
  • the term“vector” or“plasmid” refers to a vehicle by which a DNA or RNA sequence (e.g., a foreign gene) can be introduced into a host cell, so as to transform the host and promote expression (e.g., transcription and translation) of the introduced sequence.
  • Vectors are transfected into the cells and the DNA may be integrated into the genome by homologous recombination in the case of stable transfection, or the cells may be transiently transfected.
  • the vector is a bacterial, yeast, baculoviral, plant or mammalian expression vector.
  • Any of the known procedures for introducing foreign nucleotide sequences into host cells may be used. These include the use of calcium phosphate transfection, polybrene, protoplast fusion, electroporation, nucleofection, liposomes, microinjection, naked DNA, plasmid vectors, viral vectors, both episomal and integrative, and any of the other well-known methods for introducing cloned genomic DNA, cDNA, synthetic DNA or other foreign genetic material into a host cell (see, e.g., Sambrook et al.).
  • mammalian expression vectors examples include the adenoviral vectors, the pSV and the pCMV series of plasmid vectors, vaccinia and retroviral vectors, as well as baculovirus.
  • the promoters for cytomegalovirus (CMV) and SV40 are commonly used in mammalian expression vectors to drive gene expression.
  • the present invention provides a method for producing the recombinant DAO comprising the sequential steps of cloning a nucleotide sequence encoding the DAO into an expression vector, transforming a host cell, specifically a mammalian cell with said vector, cultivating the transformed host cell under conditions wherein the DAO is expressed, isolating the DAO from the host cell culture, optionally by disintegrating the host cells or isolating the DAO from cell culture supernatant, and optionally purifying the DAO.
  • a pharmaceutical composition comprising the recombinant DAO provided herein.
  • such pharmaceutical composition comprising the DAO or its functional variants as described herein is used for the treatment of any condition associated with excess histamine, specifically of excess histamine of >1 ng/ml plasma concentration, specifically for the treatment of chronic allergic diseases, more specifically for the treatment of anaphylaxis, anaphylactic shock, chronic urticaria, acute urticaria, asthma, hay fever, allergic rhinitis, allergic conjunctivitis, histamine intoxication, headache, itching, vomiting, tachycardia, hypotension, cardiac arrest, atopic dermatitis inflammatory diseases, mastocytosis, mast cell activation syndrome (MCAS), pre-eclampsia, hyperemesis gravidarum, pre term labor, peptic ulcers, acid reflux, pruritus, and sepsis.
  • MCAS mast cell activation syndrome
  • the pharmaceutical composition described herein further comprises pharmaceutically acceptable carriers or excipients, such as for example bulking agents, when used for diagnosis or therapy.
  • pharmaceutically acceptable carriers or excipients such as for example bulking agents
  • These pharmaceutical compositions can be administered in accordance with the present invention as a bolus injection or infusion or by continuous infusion.
  • Pharmaceutical carriers suitable for facilitating such means of administration are well-known in the art.
  • Pharmaceutically acceptable carriers generally include any and all suitable solvents, dispersion media, coatings, isotonic and absorption delaying agents, and the like that are physiologically compatible with the DAO provided by the invention. Further examples of pharmaceutically acceptable carriers include sterile water, saline, phosphate buffered saline, dextrose, glycerol, ethanol, and the like, as well as combinations of any thereof.
  • Liquid formulations can be solutions, emulsions or suspensions and can include excipients such as suspending agents, solubilizers, surfactants, preservatives, and chelating agents.
  • Exemplary formulations as used for parenteral administration include those suitable for subcutaneous, intramuscular or intravenous injection as, for example, a solution, emulsion or suspension.
  • the DAO described herein is specifically administered at a therapeutically effective amount, meaning a quantity or activity sufficient to effect beneficial or desired results, including clinical results, when administered to a subject, e.g. a patient suffering from cancer.
  • a therapeutically effective amount meaning a quantity or activity sufficient to effect beneficial or desired results, including clinical results, when administered to a subject, e.g. a patient suffering from cancer.
  • an effective amount or synonymous quantity thereof depends upon the context in which it is being applied.
  • An effective amount is intended to mean that amount of a compound that is sufficient to treat, prevent or inhibit such diseases or disorders.
  • the amount of the compound, i.e. the recombinant DAO described herein, that will correspond to such an effective amount will vary depending on various factors, such as the given drug or compound, the pharmaceutical formulation, the route of administration, the type of disease or disorder, the identity of the subject or host being treated, and the like, but can nevertheless be routinely determined by one skilled in the art.
  • a fusion polypeptide wherein the recombinant DAO is conjugated to a second moiety, which can be, but is not limited to Fc or human serum albumin (HSA).
  • a second moiety which can be, but is not limited to Fc or human serum albumin (HSA).
  • the DAO conjugated to and Fc comprises any one of SEQ ID NOs: 40 to 70 or a functional fragment thereof having at least 80%, specifically at least 85%, 90%, 95%, 99% sequence identity with any one of SEQ ID NOs:40 to 70.
  • the DAO conjugated to and Fc is encoded by any one of SEQ ID NOs: 72 to 102 or by a fragment thereof having at least 80%, specifically at least 85%, 90%, 95%, 99% sequence identity with any one of SEQ ID NOs:72 to 102.
  • fusion polypeptide in the context of the present invention concerns a sequence of amino acids, predominantly (but not necessarily) connected to each other by peptide bonds.
  • the term“fused” in accordance with the fusion polypeptide of the present invention refers to the fact that the amino acid sequences of at least two different origins, namely, the modified DAO as herein defined and the second moiety, specifically the Fc domain of human IgG or albumin, are linked to each other by covalent bonds either directly or via an amino acid linker or spacer, joining (bridging, conjugating, covalently binding) the amino acid sequences.
  • the fusion may be performed by chemical conjugation or by genetic engineering methods that are well known in the art.
  • the DAO polypeptide as herein defined is covalently linked through its C-terminus to either the Fc domain of human IgG or to HSA.
  • the fusion polypeptide according to the invention comprises the DAO polypeptide and either the Fc domain component or HSA.
  • the DAO polypeptide as herein defined is covalently linked through its N-terminus to either the Fc domain of human IgG or to HSA.
  • the fusion polypeptide of the invention comprises the Fc domain component or HSA and the DAO polypeptide.
  • polypeptide refers to amino acid residues, connected by peptide bonds.
  • a polypeptide sequence is generally reported from the N-terminal end containing free amino group to the C-terminal end containing free carboxyl group.
  • a polypeptide may also be termed amino acid sequence, peptide, or protein and can be modified, for example, by manosylation, glycosylation, amidation, carboxylation or phosphorylation.
  • covalently linked or “covalently linking” it is meant that the indicated domains are connected or linked by covalent bonds.
  • Fc fusion polypeptide encompasses the DAO of the present disclosure comprising a full length Fc domain as well as proteins comprising Fc domain fragments (e.g., a full CH2 domain, a full CH3 domain, a CH2 fragment, a CH3 fragment, or combinations thereof).
  • An Fc fusion protein may also comprise all or a portion of the hinge region.
  • the Fc region includes the polypeptides comprising the constant region of an antibody excluding the first constant region immunoglobulin domain, and fragments thereof.
  • Fc refers to the last two constant region immunoglobulin domains of IgA, IgD, and IgG, and the last three constant region immunoglobulin domains of IgE and IgM, and optionally the flexible hinge region N-terminal to these domains.
  • the Fc region can include the J chain.
  • Fc comprises immunoglobulin domains Cgamma2 and Cgamma3 (Cy2 and Cy3) and optionally the hinge region between Cgammal (Cy1 ) and Cgamma2 (Cy2).
  • the human IgG heavy chain Fc region is usually defined to comprise residues C226 or P230 to its carboxyl-terminus, wherein the numbering is according to the EU index as set forth in Kabat (Kabat et al., Sequences of Proteins of Immunological Interest, 5th Ed. Public Health Service, National Institutes of Health, Bethesda, Md. (1991 )).
  • Fc can refer to this region in isolation, or this region in the context of an antibody, antibody fragment, or Fc fusion protein.
  • the HSA sequence fused to the DAO polypeptide described herein can comprise the wild type sequence or 90%, specifically at least 95%, more specifically at least 99%, more specifically at least 99.9% sequence identity with the wild type sequence (SEQ ID No. 103).
  • a linker sequence is contained between DAO and HSA, specifically comprising 2 to about 10 amino acid residues.
  • GAG binding of DAO specifically heparin/heparan sulfate binding is inhibited thus leading to decreased internalization of DAO and increased amount of DAO in the body ' s circularization which can be determined by AUC.
  • the DAO indeed shows significantly decreased heparin/heparan sulfate binding.
  • a further option to increase DAO in the body ' s circularization is to provide a target- specific ligand specifically binding to the heparin/heparan sulfate binding domain.
  • an antibody or antibody fragment or any ligand may bind to DAO close to the heparin binding domain and thereby blocks access to the heparin binding domain.
  • it is a fusion protein where parts of the fusion protein cover and block the function of the heparin binding domain and therefore have the same effect as mutations or antibody binding directly to the heparin binding domain.
  • the ligand can be an antigen binding protein, specifically selected from the group consisting of antibodies or antibody fragments, such as any of Fab, Fd, scFv, diabodies, triabodies, Fv tetramers, minibodies, nanobodies, single-domain antibodies like VH, VHH, IgNARs, or V-NAR; antibody mimetics, such as AdnectinsTM ( sharing with antibody variable domains a beta-sheet sandwich fold with diversified loops, but differing from antibodies in primary sequence and having a single-domain structure without disulfide bonds), Affibodies® (small, simple proteins composed of a three-helix bundle based on the scaffold of one of the IgG-binding domains of Protein A), Affilins® (structurally derived from human ubiquitin, constructed by modification of surface- exposed amino acids of these proteins and isolated by display techniques such
  • Affilins resemble antibodies in their affinity and specificity to antigens but not in structure, which makes them a type of antibody mimetic
  • Affimers® small proteins that bind to target molecules with similar specificity and affinity to that of antibodies
  • Affitins artificial proteins with the ability to selectively bind antigens
  • Alphabodies Aptamers
  • Anticalins Avimers
  • DARPins® genetically engineered antibody mimetic proteins typically exhibiting highly specific and high-affinity target protein binding
  • Fynomers® small binding proteins (7 kDa) derived from the human SH3 domain of Fyn kinase which can be engineered to yield specific and high-affinity binding domains to target the specific proteins
  • Kunitz domain peptides monobodies, or NanoCLAMPS (CLostridal Antibody Mimetic Proteins)
  • fusion proteins comprising one or more immunoglobulin-fold domains, antibody domains or antibody mimetics.
  • structure coordinates refers to a set of values that define the position of one or more amino acid residues with reference to a system of axes.
  • the term refers to a data set that defines the three-dimensional structure of a molecule or molecules (e.g., Cartesian coordinates, temperature factors, and occupancies). Structural coordinates can be slightly modified and still render nearly identical three-dimensional structures. A measure of a unique set of structural coordinates is the root mean square deviation of the resulting structure.
  • Structural coordinates that render three-dimensional structures (in particular, a three-dimensional structure of a heparin/heparin sulfate binding domain) that deviate from one another by a root mean square deviation of less than 3 A, 2 A, 1.5 A, 1.0 A, or 0.5 A may be viewed by a person of ordinary skill in the art as very similar.
  • constructing a computer model includes the quantitative and qualitative analysis of molecular structure and/or function based on atomic structural information and interaction models.
  • modeling includes conventional numeric-based molecular dynamic and energy minimization models, interactive computer graphic models, modified molecular mechanics models, distance geometry, and other structure-based constraint models.
  • fitting program operation refers to an operation that utilizes the structure coordinates of a chemical entity, an enzymatically active center, a binding pocket, molecule or molecular complex, or portion thereof, to associate the chemical entity with the enzymatically active center, the binding pocket, molecule or molecular complex, or portion thereof. This may be achieved by positioning, rotating or translating the chemical entity in the enzymatically active center to match the shape and electrostatic complementarity of the enzymatically active center. Covalent interactions, non-covalent interactions such as hydrogen bond, electrostatic, hydrophobic, van der Waals interactions, and non-complementary electrostatic interactions such as repulsive charge-charge, dipole-dipole and charge-dipole interactions may be optimized. Alternatively, one may minimize the deformation energy of binding of the chemical entity to the enzymatically active center.
  • a recombinant diamine oxidase (DAO) with decreased glycosaminoglycan binding affinity wherein said DAO comprises at least one amino acid modification in the glycosaminoglycan (GAG) binding domain.
  • the recombinant DAO of item 1 further comprising at least one modification of solvent accessible cysteine at amino acid position 123 with reference to the numbering of SEQ ID No. 1 , specifically the modification of the cysteine is an amino acid substitution, deletion or coupling with a chemical moiety.
  • X1 can be by any amino acid, specifically it is A or S, more specifically it is S;
  • X2 can be by any amino acid, specifically it is K;
  • X3 can be by any amino acid, specifically it is A or T, more specifically it is T,
  • X4 can be by any amino acid, specifically it is K, and
  • X5 can be by any amino acid, specifically it is K or T, more specifically it is T.
  • the recombinant DAO of item 7 or 8 comprising the amino acid sequence selected from the group consisting of SFKAKLPK (SEQ ID NO:33), AFKAKLPT (SEQ ID NO:34), AFKTKLPK (SEQ ID NO:35), SFKTKLPK (SEQ ID NO:36), AFKTKLPT (SEQ ID NO:37), SFKAKLPK (SEQ ID NO:38).
  • a fusion polypeptide comprising the recombinant DAO of any one of items 1 to 14 and an Fc domain of human IgG or human serum albumin (HSA), wherein the fusion polypeptide retains the functional activity of the recombinant DAO.
  • a recombinant vector comprising the nucleotide sequence of item 16, specifically the vector is a bacterial, yeast, baculoviral, plant or mammalian expression vector.
  • An expression cassette comprising the nucleotide sequence of item 17, operably linked to regulatory elements.
  • a recombinant host cell or a host cell line comprising the recombinant DAO of any one of items 1 to 15, wherein the host cells are selected from the group consisting of CHO cells, Vero cells, MDCK cells, Pichia pastoris cells, SF9 cells.
  • An expression system comprising the vector of item 17 or the expression cassette of item 18 and a host cell or host cell line of item 19.
  • composition comprising the recombinant DAO of any one of items 1 to 15 and optionally one or more excipients.
  • MCAS mast cell activation syndrome
  • antibodies or antibody fragments such as any of Fab, Fd, scFv, diabodies, triabodies, Fv tetramers, minibodies, nanobodies, single-domain antibodies like VH, VHH, IgNARs, or V-NAR;
  • antibody mimetics such as AdnectinsTM, Affibodies®, Affilins®, Affimers®, Affitins, Alphabodies, Aptamers, Anticalins, Avimers, DARPins®, Fynomers®, Kunitz domain peptides, Monobodies, or NanoCLAMPS; or
  • fusion proteins comprising one or more immunoglobulin-fold domains, antibody domains or antibody mimetics.
  • a method for identifying compounds which modulate the heparin binding of the DAO comprising the steps of
  • Amino acids in the GAG binding (heparin/heparan sulfate-binding domain) of DAO were mutated. After mutations in the heparin-binding domain of DAO, animal studies were performed with these mutants. The short alpha half-life could be almost eliminated and the beta half-life increased to 6 hours in rats.
  • the alpha half-life refers to the rate of decline in plasma concentrations due to the process of drug redistribution from the central to the peripheral compartment
  • the beta half-life refers to the rate of decline due to the process of drug elimination due to metabolism or excretion.
  • the area under curve (AUC) increased more than 20-fold.
  • anaphylaxis or MCAS events last a few hours to 1 to 2 days, and anaphylaxis may be biphasic in 10- 20% of patients meaning that a second episode may occur within 24 hours.
  • PK pharmacokinetic
  • DAO When DAO were expressed in CHO cells, certain percentages of DAO molecules ( ⁇ 20% to 30%) formed not only dimers but also tetramers, hexamers and even octamers.
  • DAO constructs having 2 point mutations in the heparin/heparan sulfate-binding domain and a single mutation in a distinct cysteine are specific embodiments.
  • Hepmut4 mutation showed the strongest loss of binding to heparin.
  • Hepmut6 is a triple mutation replacing 570/571/572 with Gly/Gln/Thr, which is present in rodents.
  • the glutamine in the rodent sequence can also bind negatively charged sulfate and can sometimes replace arginine or lysine. All animal experiments were done in rodents so far (mice and rats).
  • FIG. 2 shows the Heparin-sepharose elution profiles of recombinant human DAO wild type (WT) and heparin mutants.
  • Hepmut variants are eluted earlier compared to DAO_WT
  • Purified DAO_WT and hepmut variants were loaded onto a HiTrap Heparin HP (High Performance) 1 ml column using a 50 mM HEPES buffer, pH 7.4 and a flow rate of 0.2 ml/min.
  • Table 2 and figure 3 show the raw results but also normalized based on data using the DAO wild-type protein.
  • the mean and the standard deviation (SD) from the two salt experiments were calculated and presented as bar graph.
  • the numbers above the bars correspond to the numbers in the table.
  • DAO_WT they represent the salt concentration of elution.
  • the difference to the DAO_WT salt concentration is shown.
  • DAO_WT was eluted from the heparin sepharose at 372 mM NaCI or 310 mM KCI salt concentration. Hepmuts were eluted at significantly lower salt concentrations.
  • the correlation coefficient R between the NaCI and KCI elution profiles is 97% with a p- value of 0.0056. Therefore, it seemed justified to combine both profiles and calculate a mean with SD.
  • the mean plus/minus SD are represented by the bar height (mean) and by the error bars (plus/minus SD).
  • Figure 3 shows Hepmut 1 , 4 and 7 variants that are eluted from heparin-sepharose at 50% lower salt concentrations compared to DAO_WT.
  • the data are from Table 2.
  • Table 3 shows the delta salt concentration from DAO_WT versus mutants for
  • NaCI and KCI NaCI and KCI.
  • 200 mM means that 200 mM less NaCI were necessary to elute the mutant from the heparin-sepharose compared to DAO_WT.
  • Hepmut4 might be the weakest heparin-binding mutant but the difference to Hepmutl and Hepmut7 is not significant. Mutating a single lysine residue in Hepmut2 reduces the affinity to heparin-sepharose. Serum and plasma contain about 145 to 150 mM Na+ and K+ combined and 100 mM Cl- ions. Elution of Hepmutl , 4 and 7 variants from the heparin-sepharose is close to the physiological concentration of ions in serum and therefore these mutants should be minimally active in vivo and this is the case as shown below in vitro using cells and in vivo in rats and in mice.
  • Endothelial cells are the first cells (except blood cells) exposed to DAO after intravenous administration. They are in direct contact with blood. They also exposed to DAO after subcutaneous administration because DAO will be transported via the lymph system into the blood compartment.
  • SK-Hep1 cells Immunofluorescence microscopy of SK-Hep1 cells, an endothelial cell-like immortal cell line from a patient with liver cancer, after incubation with DAO_WT and Hepmut variants showed that internalization of Hepmut variants was inhibited.
  • ABSP1 amiloride binding protein 1 , alternative name for DAO
  • H+L Alexa Fluor 488 donkey anti-rabbit
  • Hepmut4 and Hepmut7 variants showed strongly reduced uptake into the SK- Hep1 cells, whereas Hepmutl caused some staining similar to the vesicular-like staining of DAO_WT.
  • These results not only demonstrated that Hepmut DAO variants block uptake into EC, but also for the first time that DAO is internalized by cells. It has been shown that DAO binds to the surface of EC, and DAO has been localized inside cells, but incubation of cells with DAO and proof that DAO_WT is internalized implying the existence of a DAO receptor.
  • Figure 4 shows a Western blot of SK-Hep1 cell lysates after incubation with DAO_WT and Hepmut variants A.
  • Lane 1 Negative control
  • 2 rhDAO_WT
  • 3 rhDAO-Hepmutl
  • 4 rhDAO-Hepmut4
  • 5 rhDAO-Hepmut7.
  • the cells were then lysed with RIPA buffer and sonication.
  • the cell lysates were loaded onto a SDS-PAGE gel, followed by blotting onto a PVDF membrane.
  • the membrane was incubated after blocking with a 1 : 1000 dilution of a serum IgG fraction from rabbits immunized with purified rhDAO. This step was followed by incubation with a 1 :5000 dilution of b-actin mABAC-15 (Invitrogen).
  • DAO_WT and Hepmut4 variants to SK-Hep1 cells in an in vitro assay Binding of DAO_WT and Hepmut4 variants to SK-Hep1 cells in an in vitro assay is about 5-times lower.
  • DAO was labelled with Alexa488 fluorescent dye on the glycosaminoglycans and incubated with SK-HEP1 cells. This assay is performed in microtiter plates. The fluorescent signal is measured after washing and cell lysis.
  • Hepmut4 variant shows reduced binding to SK-Hep1 cells compared to DAO_WT.
  • SK-Hep1 cells were grown in a 96-well plate and incubated with 0 to 8 pg/ml Alexa488-labelled rhDAO_WT and rhDAO-Hepmut4 for 60 minutes at 37°C.
  • the cells were washed twice with 150 mM glycine buffer with 150 mM sodium chloride, pH 3.0 and once with PBS to remove membrane-bound DAO.
  • After cell lysis using RIPA buffer the fluorescence intensities were determined using a Tecan plate reader. The means of triplicates with the standard errors of the mean (SEM) are shown.
  • Figure 6 provides the ITC data of DAO_WT and Hepmut4.
  • the buffer was 50 mM HEPES with 150 mM KCI pH 7.3. Binding was only observed for rhDAO_WT and HMWH with a KD value of 423 nM.
  • DAO_WT and Hepmut4 protein were injected at 1 mg/kg into the tail vein of C57BL6 mice with a body weight of about 20 gram. Protein concentrations and enzymatic activity of the two purified DAO variants were comparable. Protein purification was performed as published recently (Gludovacz 2016). Linear and log y- axis scales are shown.
  • ⁇ AUC Area Under the Curve
  • the half-life was calculated from 60 to 1680 minutes to exclude the fast alpha distribution half-life using DAO_WT, which is about 10 minutes. Using the Hepmut4 variant this very rapid elimination of DAO from the circulation is more or less not present anymore. There is a high curve fit using a mono-exponential decay function from 60 to 1680.
  • DAO_WT and Hepmut4 protein was injected intraperitoneally at 1 mg/kg in mice with a body weight of 21 gram.
  • Hepmut4 increases the AUC (Area Under the Curve) more than 16-fold compared to DAO_WT protein after intraperitoneal injection.
  • Each time point represents the mean of 3 mice and therefore in total 15 mice DAO_WT and 15 mice Hepmut4 were used. The means with the standard deviations are shown.
  • DAO concentrations were measured using a recently published human DAO ELISA (Boehm 2017).
  • AUC data are summarized in the following table. Half-life data are not included because we would need to assume that the absorption of DAO_WT and Hepmut4 from the intraperitoneal space is the same and this might not be the case.
  • Table 5 The AUC is increased 16-fold in Hepmut4 versus DAO_WT treated mice.
  • ⁇ AUC Area Under the Curve
  • Figure 9 shows means of the measured values plus/minus the standard deviation
  • SD using 1 mg/kg DAO wild-type and different Hepmut variants. Slow clearance of Heparin-binding domain mutants compared to DAO wild-type protein administered at 1 mg/kg.
  • Figure 10 exhibits the slow clearance of Heparin-binding domain mutants compared to DAO wild-type protein administered at 1 mg/kg.
  • DAO_WT and Hepmut7 show a fast alpha half-life and two equations are used to derive the best fit curve. Nevertheless, the alpha half-life for Hepmut7 is significantly longer compared to DAO_WT. The half-lives are shown below. For Hepmutl and Hepmut4 mono-exponential decay shows the best fit with the highest adjusted R square and lowest p-value. This can be also seen in the figure with the original data.
  • FIG 11 Slow clearance of Heparin-binding domain mutants compared to DAO wild-type protein administered at 1 mg/kg.
  • Figures 12, 13, and 14 show the first 90 minutes to see the fast clearance using DAO wild-type protein.
  • Figure 12 shows slow clearance of Heparin-binding domain mutants compared to DAO wild-type protein administered at 1 mg/kg.
  • Figure 13 shows slow clearance of Heparin-binding domain mutants compared to DAO wild-type protein administered at 1 mg/kg.
  • the curves have been generated using the best fit exponential equations; Linear y-axis scale.
  • Figure 14 shows slow clearance of Heparin-binding domain mutants compared to DAO wild-type protein administered at 1 mg/kg.
  • Table 8 Elimination of the very fast alpha half-life in DAO wild-type and increase in the beta half-life in heparin-binding mutants.
  • Fc-DAO fusion variants were tested with the heparin-binding mutations and the PK parameters further improved with a beta half live of 9 hours and increased AUC. Amino acids involved in the high affinity interaction with Fc_gamma receptor were removed and amino acids involved in the interaction with FcRN have not been altered.
  • Fc-DAO fusion protein shows similarly to the DAO wild-type protein a very fast alpha distribution half-life. Most of the fusion variant is removed from plasma within 20 minutes. Afterwards the half-life is about 120 minutes calculated using the 30, 120 and 240 time point values.
  • Fc-Hepmut4 is much more stable in plasma.
  • the DAO clearance mechanism is clearly dominant over the Fc part.
  • the half-life of human IgGs in rats is several days and this half-life is mainly determined by binding of the Fc part to the FcRN receptor.
  • Figure 15 shows the rapid clearance of Fc-DAO wild-type compared to Fc- Hepmut4 administered at 1 mg/kg in 6 or 4 rats respectively. The means with the standard deviations are shown; Linear y-axis scale.
  • Figure 16 shows the rapid clearance of Fc-DAO wild-type compared to Fc- Hepmut4 administered at 1 mg/kg in 6 or 4 rats respectively. The means with the standard deviations are shown; Log y-axis scale.
  • Both data sets can be best fit to a mono-exponential decay function with p-values of less than 0.001 and adjusted R square values of > 97%.
  • the half-life after 30 minutes was calculated to be 120 minutes based on the data from time points 30, 120 and 240 minutes.
  • a two factor decay exponential curve fitting did not converge.
  • the best fit equations are used to extrapolate the Fc-DAO data to 24 hours. The curves are shown below.
  • Fc-DAO-Hepmut4 shows a strong increase in the AUC after intravenous administration of 1 mg/kg; Log y-axis scale.
  • Fc-DAO-Hepmut4 shows a strong increase in the AUC after intravenous administration of 1 mg/kg; Linear y-axis scale.
  • Fc-Hepmut4 variants are more stable in plasma compared to Fc-DAO. This is in agreement with mice and rat data using non-fusion DAO variants. Nevertheless, the half- life of Fc-Hepmut4 is still rather short compared to IgG antibodies. DAO clearance seems still dominant over slower Fc clearance mechanisms.
  • Cys123 is on the surface and this is unusual.
  • the amino acid cysteine is the rarest and the“least and highest” conserved amino acid in proteins (Marino SM and Gladyshev VN, J Mol Biol. 2010 Dec 17;404(5):902-16), likely because it is available for oxidation.
  • DAO produces hydrogen peroxide, which might cause exactly this oxidation of cys123 and consequently it can form a disulfide bond which might severely disturb function. It is highly conserved in enzymes as catalytic amino acid and if involved in disulfide bond formation, as it is also the case in DAO. Cys633 is deeper inside the structure and less accessible and may not play a role in aggregate formation. It might play a role at high DAO concentrations.
  • DAO dimer possesses two accessible Cys123 amino acids, one dimer can form a disulfide bridge with another dimer resulting in a tetramer, but it can also interact with two dimers forming a hexamers, etc.
  • the molecular weight of DAO lacking the secretion signal purely based on amino acids (732) would be 166872 Da for the dimer.
  • the tetramer would be 333744 Da, the hexamer 500617 Da and the octamer 667489 Da but the glycans will increase this by probably about 25% (Elmore, 2002).
  • the height of a DAO monomer or dimer is about 65 A but increases to 130 A in the tetramer, 195 A and 260 A in the hexamer and octamer respectively.
  • the aggregate might be rigid or flexible. These aggregates are certainly more immunogenic because neo-epitopes might be created between two dimers and repeated 2 or 3 times with potential and likely negative consequences for efficacy and safety (see below).
  • Table 12 Molecular weight of DAO monomer to octamer using 25% glycan weight
  • Figure 19 lane 1 : HiMark Standard; lane 2: Negative Control (empty plasmid); lane 3: rhDAO WT; lane 4: rhDAOA123; lane 5: rhFc-DAO; lane 6: rhFc-DAOA123; lane 7: rhDAO-Hepmut4; lane 8: rhDAO-Hepmut4A123; lane 9: rhFc-DAO-Hepmut4; lane 10: rhFc-DAO-Hepmut4A123.
  • rhFc recombinant human Fc fusion protein with DAO; 15 pi of each culture supernatant were loaded. SDS-PAGE was performed under non reducing conditions.
  • Antibody MUV rabbit serum #408, 1 :5000.
  • Cys123 to Ala123 mutation completely prevented tetramerization and higher order aggregate formation of recombinant human wild-type DAO and Hepmut4 variants. There is no effect in the rhFc-DAO fusion constructs. This implies that aggregate formation in these Fc fusion variants is not caused by Cys123 but more likely by the Fc part, which contains also cysteines.
  • the signal intensity of each lane was determined using ImageJ software to roughly quantify the percent of higher n-meric variants. To compare the WT and the corresponding cys123 mutant lanes, equally sized areas were selected (as indicated) and a signal profile was generated. The area under the curve (AUC) for each lane was calculated.
  • the mean (SD) difference between Cys123 and Ala123 mutation is on average combining data from replicate 1 and 2 about 19% (5.5%) for WT and Hepmut4 mutant.
  • the mean (SD) difference is -6% (15.4%) or in other words cys123 to ala123 mutation are not different.
  • the ala123 mutation has a significant advantage for manufacturing and quality control in general but also for reduction of immunogenicity and therefore this mutation is also clinically highly relevant. It is well known that aggregates are more immunogenic and therefore using this mutation the immunogenicity of rhDAO will be reduced.
  • Phusion polymerase (Thermo Fisher Scientific) was used: annealing temperature: 56.3 °C; elongation times, 4 min for 30 cycles. Ligation (T4 DNA ligase, New England Biolabs) and amplification of the final plasmids were performed. Correctness of sequence was verified by DNA sequencing (Eurofins MWG Operon). All cloning techniques were conducted according toGreen M.R. and Sambrook, J. (2012), Molecular Cloning: A Laboratory Manual 4 th Ed. Cold Spring Harbor Laboratory Press, Cold Spring Harbor, NY; and according to the manufacturer’s instructions.
  • the vascular access port is filled with a solution containing 10 pg/mL argatroban (Argatra 100 mg/ml_; Mitsubishi Pharma), 0.3 pg/mL tissue plasminogen activator (Alteplase, Actilyse, Boehringer Ingelheim) and 0.38% sodium citrate in 0.9% NaCI to prevent coagulation.
  • argatroban Argatroban
  • tissue plasminogen activator Alteplase, Actilyse, Boehringer Ingelheim
  • Venous blood withdrawals (0.5 ml_) are conducted at pre-defined time points under short isoflurane anesthesia into tubes containing sodium citrate for anticoagulation. Plasma is prepared within 4 hours and stored at -32°C until analysis. Fluid substitution (0.5 ml_) using physiological saline solution (0.9% NaCI) is provided to the animals. Animals are sacrificed after the last blood withdrawal time point under deep ketamine-xylazine (35 mg and 5 mg/kg) anesthesia by an overdose of pentobarbital (300 mg/kg). Male rats (Sprague-Dawley) with approximately 400 gram and female mice (C57BL/6N) with approximately 20 g body weight are included.
  • Male Sprague Dawley rats are purchased from commercial vendors (Janvier Labs, Le Genest-Saint-lsle, France and Division Laboratory Animal Science and Genetics, Medical University of Vienna, Himberg, Austria). The animals are housed under controlled and standardized conditions (artificial L/D cycle 12:12, room temperature 22 ⁇ 2°C, humidity 45 ⁇ 10%). The animals are kept in groups of two (Makrolon 3 cages) and are provided with environment enrichment. The animals have ad libitum access to water and to complete feed for rats (Alleinfutter fiir Ratten und Mause sniff R/M-H; sniff Spezialdiaten GmbH).
  • mice Female mice (C57BL/6N) are obtained from a commercial vendor (Charles River Laboratories, Sulzfeld, Germany and Division Laboratory Animal Science and Genetics, Medical University of Vienna, Himberg, Austria). The animals are housed under controlled and standardized conditions (artificial L/D cycle 12:12, room temperature 22 ⁇ 2°C, humidity 45 ⁇ 10%). The animals are kept in groups of five (Makrolon 2 long cages) and have ad libitum access to water and to complete feed for mice as described above for rats.
  • rhDAO Purified rhDAO, wild type rhDAO and rhDAO containing any one of mutations HepMut 1 to HepMut 7 or any of HepMutl to HepMut4 further comprising Cys123 and/or Asn168Gln mutations, is intravenously administered at 1 mg/kg into rats and mice and blood samples are drawn at the indicated time points.
  • DAO antigen concentrations are measured using a recently published human DAO ELISA (Boehm T. et al., 2017, Clin. Biochem., 50, 444-451).
  • the distribution (alpha) and elimination (beta) half-lives are approximately 3 and 230 minutes respectively in rats and approximately 11 and 110 minutes respectively in mice. In rats more than 90% of the injected dose is removed from the plasma pool within 10 minutes. The rapid clearance in mice is somewhat slower.

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